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Individual

DR. BENITA L BONSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1279 HIGHWAY 54 W, SUITE 220, FAYETTEVILLE, GA 30214-4552
(770) 991-2200
(770) 991-1341
Mailing address
1279 HIGHWAY 54 WEST, SUITE 220, FAYETTEVILLE, GA 30214-4552
(770) 991-2200
(770) 991-1341

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
053980
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
223286848A
GA
Enumeration date
08/10/2006
Last updated
10/22/2011
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